A nested case-control study found that women of reproductive age using hormonal contraception were more likely to subsequently initiate semaglutide for weight management. The findings suggest that weight gain and metabolic symptoms associated with hormonal contraceptive use may contribute to increased demand for anti-obesity treatment. The study was published in JAMA Network Open by Mille D. and colleagues.
The potential for using particular hormone contraception to predict subsequent use of semaglutide was tested using register data collected on all women aged 12-49 years old residing in Denmark during January 1, 1996, to December 31, 2023. Subjects were selected as women who had a first-time prescription for semaglutide with no record of any other prescriptions for glucose-lowering drugs, with the first day of such prescription designated as the index date. Every semaglutide user was individually matched according to their birth year by 10 individuals with no history of using antidiabetic drugs.
The main exposure involved the sequential history of all hormone contraceptive drug fills from the age of 12 to the index date. The statistical analysis was performed from November 2025 to May 2026 by calculating adjusted hazard ratios through conditional logistic regression.
Key findings:
- The analysis was conducted with a total of 22,694 cases and 229,640 matched controls (249,634 participants; median age, 37 years).
- Results demonstrated that all patterns of hormonal contraceptive use differed in association with initiation of semaglutide compared to non-user controls.
- When examining the patterns with one type of contraceptive used, adjusted hazard ratios ranged between 1.42 (95% CI, 1.34-1.51) for combined oral pills and 1.63 (95% CI, 1.46-1.82) for progestin-only IUDs.
- In patterns where 2 or more contraceptives were involved, the hazard ratios were found to range from 1.64 (95% CI, 1.47-1.82) for combined oral tablets followed by progestin-only pills to 2.11 (95% CI, 1.97-2.25) for other patterns of use.
- The adjustment for BMI weakened but did not eliminate the association.
- Subgroup analyses by age, education level, income, parity, immigrant status, and semaglutide type indicated consistent results across many patterns of use.
In conclusion, the use of hormonal contraceptives has been identified as a predictor of semaglutide use in all usage scenarios relative to the control group. This finding suggests a need to explore the factors influencing weight management among women. It is essential for the medical team to understand the connection between these two aspects of health in order to provide appropriate counseling for women on both issues.
Reference:
Bager MD, Wood-Kurland HK, Sørensen KK, et al. Hormonal Contraception and Initiation of Semaglutide Therapy. JAMA Netw Open. 2026;9(7):e2624382. doi:10.1001/jamanetworkopen.2026.24382
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